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Pharmacology Pictures - Exam 1
Terms in this set (98)
When administering drugs, the nurse remembers that the duration of a drug is defined as what?
the time period at which a drug's concentration is sufficient to cause a therapeutic response
The nurse is reviewing a list of verbal medication orders. What is the proper notation of the dose of the drug ordered?
When a patient is taking an adrenergic drug, the nurse expects to observe which effect?
increased heart rate
A 25 year-old woman is visiting the prenatal clinic and shares her desire to go "natural" with her pregnancy. She shows the nurse a list of herbal remedies that she wants to buy so that she can "avoid taking any drugs". What should the nurse say?
"It's important to remember that herbal remedies do not have proven safety ratings for pregnant women"
A patient has been taking donepezil (Aricept) for 2 weeks as part of the treatment for early stages of Alzheimer's disease. Her daughter calls the prescriber's office and is upset because "Mother has not improved one bit!" What should be the nurses response?
"It may take up to 6 weeks to see an improvement"
During an admission assessment, the nurse discovers that the patient does not speak English. What is considered the ideal resource for translation?
A translator who does not know the patient
A patient has received an accidental intravenous overdose of Atropine. Which drug will the nurse prepare to administer?
The patient is experiencing chest pain and needs to take a sublingual form of Nitroglycerin. Where does the nurse instruct the patient to place the tablet?
Under the tongue
A 49 year-old patient is in the clinic for a follow-up visit 6 months after starting a beta blocker for treatment of hypertension. During the visit, his blood pressure is 169/98mmHg, and he eventually confesses that he stopped taking his medicine 2 months ago because of an "embarrassing problem". What problem did the patient most likely experience with this medication that caused him to stop taking it?
Impotence (inability to have an erection)
The nurse is aware that adrenergic drugs produce effects similar to which nervous system?
sympathetic nervous system
The patient is to receive oral guaifenesin (Mucinex) twice a day. Today, the nurse was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?
A 60 year-old patient is on several new medications and expresses worry that she will forget to take her pills. What action by the nurse would be most helpful in this situation?
assisting the patient with obtaining and learning to use a calendar or pill container
The nurse recognizes that adrenergic drugs cause relaxation of the bronchi and bronchodilation by stimulating what type of receptors?
Beta 2 adrenergic
A patient is going home with a new prescription for the beta-blocker Atenolol (Tenormin). The nurse will include what content when teaching about this drug?
Never stop taking this medication abruptly
The nurse is reviewing dietary supplements and recalls that the FDA requires manufactures of dietary supplements to
identify the active ingredients on the label
When monitoring a patient who is taking a low-dose cholinergic drug, the nurse will watch for what cardiovascular effect?
The nurse is reviewing the use of anticholinergic drugs. Anticholinergic drugs block the effects of what nervous system?
Parasympathetic nervous system
A patient who has abdominal surgery has been discharged on a cholinergic drug to assist in increasing gastrointestinal peristalsis. The nurse will teach this patient to look for what therapeutic effect?
passage of flatus
A patient has been selected as a potential recipient of an experimental drug for heart failure. The nurse knows that when informed consent has been obtained, it indicated what?
The patient has has the study's purpose, procedures, and the risks involved explained to him
The nurse will monitor for what adverse effect when administering an anticholinergic drug?
The nurse working in a preoperative admitting unit administers an anticholinergic medication to a patient before surgery. What is the purpose of this drug in the preoperative setting?
Reduce oral and gastrointestinal secretions
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
monitor plasma drug levels
The nurse is providing teaching regarding drug therapy to the husband of a woman with Alzheimer's disease. She was diagnosed 3 months ago, his mild memory loss, and will be receiving donepezil (Aricept). What is the drug's expected action?
May help to improve the mood and decrease confusion
For what cultural group must the health care provider respect the value placed on preserving harmony with nature and the belief that disease is a result of ill spirits?
The nurse is reviewing a patient's medication history and notes that the patient is taking the cholinergic blocker tolterodine (Detrol). What is an indication for this medication?
If a clinician wanted to counteract the effects of a drug the patient has already taken, what type of drug would be of the most use?
When discussing dosage calculation for pediatric patients with a clinical pharmacist, the nurse notes that what type of dosage calculation is used most commonly in pediatric calculations?
milligram per kilogram of body weight formula
The patient is asking the nurse about the current US laws and regulations of herbal products. According to the Dietary Supplement and Health Education Act of 1994, what statement is true?
medicinal herbs are viewed as dietary supplements
Drug transfer to the fetus is ore likely during the last trimester of pregnancy for what reason?
enhanced blood flow to the fetus
The medication order reads, "Give ondansetron (Zofran) 4mg, 30 minutes before beginning chemotherapy to prevent nausea" . The nurse notes that the route is missing from the order. What is the nurses best action?
Contact the prescriber to clarify the route of medication ordered
An adrenergic agonist is ordered for a patient in shock. The nurse will note that this drug has had its primary intended effect if which expected outcome occurs?
increased cardiac output
What activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with hypertension?
providing education on keeping a journal of blood pressure readings
When taking a telephone order for a medication, what action by the nurse is most appropriate?
repeat the order to the prescriber before hanging up on the telephone
During initial rounds, the nurse notes that a dobutamine infusion has extravasated into the forearm of a patient. After stopping the infusion, the nurse follow standing orders and immediately injects phentolamine (Regitine) subcutaneously in a circular fashion around the extravasation site. What is the mechanism of action of the phentolamine in the situation?
It increases blood flow to the ischemic site by vasodilation to prevent tissue damage
The nurse is administering medications to the patient who is in renal failure resulting from end-stage renal disease. The nurse is aware that patients with kidney failure would most likely have problems with what pharmacokinetic phase?
List the 5 items that make up the nursing plan.
2. Nursing Diagnosis
When the nurse teaches a skill such as self-injection of insulin to the patient, what is the best way to set up the teaching/learning session?
After demonstrating the procedure, allow the patient to do several return demonstrations.
The nurse is administering parenteral drugs. What statement is true regarding parenteral drugs?
Parenteral drugs bypass the first-pass effect
The nurse is reviewing medications errors. What situation is an example of a medication error?
A patient receives a double dose of a medication because the nurse did not cut the pill in half
The nurse is assessing a newly admitted 83 year-old patient and determines that the patient is experiencing polypharmacy. What statement most accurately illustrates polypharmacy?
the patient uses multiple medications simultaneously
During a teaching session about self-monitoring while taking a beta blocker at home, the nurse has taught the patient to take his apical pulse daily for 1 minute. If the pulse rate decreases to less than 60 beats/min, the nurse will instruct the patient to:
notify his prescriber
A patient who has advanced cancer is receiving opioid medications around the clock to keep him confortable as he nears the end of his life. What term best describes this type of therapy?
The nurse is administering a stat dose of epinephrine. Epinephrine is appropriate for what situation?
An elderly patient with a new diagnoses of hypertension will be receiving a new prescription for an antihypertensive drug. The nurse expects what type of dosing to occur with this drug therpy?
the patient will receive the lowest possible dose t first, and then the dose will be increased as needed
A patient has had an overdose of an intravenous cholinergic drug. The nurse expects to administer what drug as an antidote?
The nurse is performing an assessment of a newly admitted patient. What is an example of subjective data?
the patient reports that he uses the herbal product ginko
An 83 year-old woman has been given a thiazide diuertic to treat mild heart failure. She and her daughter should be told to watch for what problems?
fatigue, leg cramps, and dehydration
The nurse is explaining the Human Genome Project to colleagues. What is the main purpose of the Human Genome Project?
to describe the entire genome of a human being
The nurse is administering drugs to neonates and will consider which factor may contribute the most to drug toxicity?
the liver is not fully developed
When given a scheduled morning medication, the patient states, "I haven't seen that pill before. Are you sure it's correct?" The nurse checks the medication administration record and verifies that it is listed. Which is the nurse's best response?
"let me check o the order first before you take it"
A 58 year-old man has had a myocardial infarction (MI), has begun rehabilitation, and is ready for discharge. He is given a prescription for metoprolol (Lopressor) and becomes upset after reading the patient education pamphlet. "I dont have high blood pressure - why did my doctor give me this medicine?" What explanation by the nurse is correct?
"studies have shown that this medication has greatly increased survival rates in patients who have had a heart attack"
After undergoing the first dose of a new antihypertensive medication, a patient complains of hives with severe itching. The nurse explains to the patient that this is caused by an allergic reaction to the drug. What body system triggers an allergic reaction?
a. Immune system
b. Nervous system
c. Circulatory system
d. Dermatologic system
The nurse administers intravenous atropine to a patient with a cardiac dysrhythmia. What would be the bioavailability of atropine in this patient?
The nurse working in a prenatal clinic recognizes that the safety or potential harm of drug therapy during pregnancy relates to which factor?
a. Fetal sex
b. Drug properties
c. Diet of the mother
d. Maternal blood type
When teaching a pregnant patient about the effects of medication on the fetus, the nurse recognizes that the greatest harm from maternally ingested medications occurs during which time period?
a. First trimester
b. Third trimester
c. Birthing process
In which gestational period is drug therapy associated with a greater incidence of drug-induced developmental defects in the newborn?
a. First trimester
b. Third trimester
c. Perinatal period
What is an alternate term for biotransformation of a drug?
A patient who has type 2 diabetes has poorly controlled blood glucose. The patient is currently taking oral medications, but they are increasingly ineffective. What term is attributed to such a condition?
d. Therapeutic index
What are the drug dosage variables that affect drug transfer to the fetus during gestation? Select all that apply.
b. Lipid solubility
c. Protein binding
d. Molecular weight
e. Duration of therapy
a & e
The nurse should use various methods of data collection for a detailed nursing assessment of the patient. What does the nurse consider to be a method of data collection?
a. Observing the patient
b. Explaining the illness to the patient
c. Changing the patient's wound dressing
d. Performing relevant diagnostic procedures
A patient with end-stage renal disease is admitted to the hospital with a complication and is in need of drug therapy. Which pharmacokinetic phase is affected by a compromised renal system?
What term means the ratio between a drug's therapeutic effects and toxic effects?
c. Cumulative effect
d. Therapeutic index
Which side effect is associated with the use of anticholinergic medications?
c. Dry mouth
d. Electrolyte imbalance
Which symptom is an example of an allergic reaction?
b. Dry eyes
d. Frequent urination
Which characteristic feature of a drug may increase the likelihood of drug transfer through breast milk?
a. Ionized drug
b. Water solubility
c. High concentration
d. High molecular weight
Drug half-life is defined as the amount of time required for 50% of a drug to do what?
a. Exert a response
b. Be absorbed by the body
c. Reach a therapeutic level
d. Be eliminated by the body
A drug given by which route is altered by the first-pass effect?
A nurse is educating a patient who is prescribed warfarin. The nurse advises the patient to avoid taking aspirin and explains that taking both drugs together may cause excessive bleeding. What is this phenomenon called?
a. Additive effect
c. Synergistic effect
d. Antagonistic effect
Which principle will the nurse follow to prevent medication errors while administering medication to patients?
a. The six rights
b. The four rights
c. The rule of five
d. The rule of nines
A patient who has rheumatoid arthritis has for many years been taking high doses of over-the-counter (OTC) acetaminophen for pain relief. Based on this information, what will the nurse review when assessing the patient?
a. Heart rate
b. Liver enzymes
c. Bowel movements
d. Creatinine and BUN
What herbal supplement may suppress the immune response?
Who has authority to reclassify prescription drug products to over-the-counter (OTC) status?
a. The primary health care provider
b. A vote by pharmacists across the nation
c. The U.S. Food and Drug Administration (FDA)
d. The Nonprescription Drugs Advisory Committee
A patient has been abusing cough syrup containing dextromethorphan. What is the term for this?
b. Reye syndrome
c. Herbal impairment
d. Cough suppression abuse
The nurse is assessing a patient's culture and race on admission to the hospital. Which concept is important for the nurse to understand regarding drug therapy as it relates to different races of individuals?
What is an "orphan drug?"
a. A drug that is used to treat cancers
b. A drug that provides symptomatic relief
c. A drug that is used to treat rare illnesses
d. A drug that is used to treat common mental illnesses
A patient has a fungal infection of the skin. Which over-the-counter medicine will be helpful for this patient?
What are five basic rights of medication administration that the nurse should keep in mind?
What is the chief purpose of the program Micromedex?
a. To provide articles citing the latest health care research
b. To provide detailed drug information in different languages
c. To collect and store the patient's health-related information
d. To provide information about various diseases and their symptoms
Which drug is a proton pump inhibitor, formerly prescription, and now over the counter?
c. Naproxen sodium
d. Chlorpheniramine maleate
Which assessment finding should the nurse interpret as a therapeutic effect of atropine?
c. Increased heart rate
d. Constriction of pupils
The patient is taking a beta blocker drug. The patient tells the nurse that she has been taking antacids frequently. The nurse recognizes that the interaction of the beta blocker and the antacid may have which result?
a. Increased activity of the antacid
b. Decreased activity of the antacid
c. Increased activity of the beta blocker
d. Decreased activity of the beta blocker
Before starting therapy with pyridostigmine, the nurse assesses the patient's history for which conditions? Select all that apply.
d. Psoriatic arthritis
e. Coronary artery disease
a & e
The nurse is caring for a patient with Parkinson disease who is receiving cholinergic-blocking drug therapy. What is the reason for prescribing this drug therapy to the patient?
a. The drug decreases the urinary bladder spasms.
b. The drug decreases muscle rigidity and tremors.
c. The drug increases the patient's apical heart rate.
d. The drug decreases gastrointestinal (GI) secretions.
Which route of administration is preferred for treating xerostomia with pilocarpine?
What is the expected therapeutic effect after the administration of atropine to a patient with cholinergic-blocker poisoning?
a. Decrease in gastric secretions
b. Immediate increase in heart rate
c. Immediate decrease in heart rate
d. Increase in respiratory rate within 1 minute
Before administering an adrenergic agonist, what is the most important assessment for the nurse to complete?
a. Skin integrity
c. Blood pressure
d. Respiratory rate
Which medication may be administered to a patient who has myasthenia gravis?
What is the medication dose of atropine that is used for symptomatic bradycardia?
a. 0.3 mg
b. 0.5 mg
c. 1.25 mg
d. 2 mg
Which finding in a patient's history is a contraindication to the administration of a cholinergic-blocking medication?
b. Irritable bowel disease
c. Angle-closure glaucoma
d. Gastrointestinal hypersecretory state
What medications are used for overactive bladder because of their decreased incidence of side effects such as dry mouth? Select all that apply.
a. b. c. e.
The nurse recognizes that which condition is an indication for the use of norepinephrine?
d. Cardiogenic shock
What is the peak plasma concentration of donepezil?
a. 5 hours
b. 1 to 2 hours
c. 3 to 4 hours
d. 30 minutes
What is the most accurate outcome criteria for the nurse to use when determining if a patient is responding appropriately to use of an adrenergic drug?
a. Patient is able to correctly state three side effects of the medication.
b. Patient is alert to time, person, and place and makes coherent conversation.
c. Patient awakens easily during nurse's morning rounds and states, "I feel fine."
d. Patient's respiratory rate is 16 breaths/minute and blood pressure is 130/72 mm Hg.
A patient has been receiving donepezil for several weeks. Which finding indicates the medication is having a therapeutic effect?
a. The patient is awake.
b. The patient is relaxed.
c. The patient has urinated.
d. The patient has increased cognition.
The nurse knows that drugs in which class may interact with adrenergic drugs?
b. Thyroid preparations
c. Nonsteroidal antiinflammatory drugs
d. Selective serotonin reuptake inhibitors
What are the uses of cholinesterase inhibitors? Select all that apply.
a. To diagnose and treat myasthenia gravis
b. To be used as an antidote in biochemical warfare
c. To relieve severe constriction of the bronchioles
d. To be used as an antidote to tricyclic antidepressant toxicity
e. To treat a patient with a prolonged history of sleep deprivation
a, b, d
Which medication is used for the treatment of irritable bowel syndrome?
What are potential side effects of administering high doses of a cholinergic-blocking medication? Select all that apply.
b. Decreased heart rate
c. Constriction of pupils
d. Decreased gastric secretions
e. Constriction of internal sphincter
a, d, e
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